MedPAC Issues Recommendations to Congress

January 25, 2019

At the January meeting, the Medicare Payment Advisory Commission
(MedPAC) recommended that Congress increase the rate for hospital
inpatient and outpatient prospective payment systems (PPS) by 2
percent in federal fiscal year (FFY) and calendar year (CY) 2020.

The commission also recommended consolidating the Hospital
Value-Based Purchasing, Hospital Readmissions Reduction, and
Hospital-Acquired Conditions Penalty programs into a new
Hospital Value Incentive Program (HVIP). The Inpatient Quality
Reporting Program would also be eliminated. The difference
between the recommended update and the amount specified under
current law would be redirected to the HVIP.

Eliminate the FFY 2020 update for skilled-nursing facilities
(SNFs), revise the SNF PPS, and annually recalibrate the relative
weights of the case-mix groups to maintain alignment of payments
and costs.

Increase the CY 2019 Medicare payment rates for physician and
other health professional services by the amount specified in
current law, require nurse practitioners (NPs) and physician
assistants (PAs) to bill the Medicare program directly, eliminate
“incident to” billing for services they provide, and refine
Medicare’s specialty designations for NPs and PAs.